RFI #
1104
Absence of ICD codes in 835
Description
In 4010 ICD-9 vol-III codes were present in 835. But this is now deleted in 5010. Can some one let me know why is this change?
RFI Response
Guide 004010X091 did include the possibility of using SVC01-1 and SVC06-1 code ID, meaning ICD-9-CM Procedure. That code refers to the ICD-9 Principal Procedure codes that are used in the 837 Institutional claim on inpatient claims. Those procedures do not represent procedures for payment, and are therefore never the basis for the payment, they are only supporting information to justify the services in general.
As a result, the ICD-9-CM Procedure code was removed from guide 005010X221 SVC01-1 and SVC06-1 as inappropriate at those locations
DOCUMENT ID
005010X221